49-20-202 - Establishment of separate risk pools.
49-20-202. Establishment of separate risk pools.
(1) The program shall establish separate risk pools for:
(a) state employees; and
(b) the Utah Children's Health Insurance Program.
(2) In accordance with participation standards established by the program, the followingentities may elect to participate in the risk pool established under Subsection (1)(a):
(a) in accordance with Subsection (3)(b), an institution of higher education designatedunder Section 53B-1-102 with a total full-time equivalent enrollment of less than 18,000;
(b) an independent entity as defined in Section 63E-1-102; and
(c) a comprehensive regional college.
(3) (a) The program shall create risk pools for other covered employers separate fromthose created in Subsection (1) as determined by the program.
(b) (i) If an institution of higher education described in Subsection (2)(a) has 1,000 ormore plan enrollees, the program shall establish a rate for the institution of higher educationbased 100% on experience; and
(ii) if the rate established under Subsection (3)(b)(i) is:
(A) less than the risk pool rate established for the state employees' risk pool, the programmay include the institution of higher education in the state employees' risk pool described inSubsection (1)(a); or
(B) more than the risk pool rate established for the state employees' risk pool, theprogram shall create a risk pool for the institution of higher education that is separate from thestate employees' risk pool under Subsection (1)(a).
Amended by Chapter 211, 2010 General Session
Amended by Chapter 318, 2010 General Session